Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Cancer Prev Res (Phila). 2021 Feb;14(2):253-262. doi: 10.1158/1940-6207.CAPR-20-0328. Epub 2020 Sep 21.
Relatively little is known about the possible effects of personalized genetic risk information on smoking, the leading preventable cause of morbidity and mortality. We examined the acceptability and potential behavior change associated with a personalized genetically informed risk tool () among current smokers. Current smokers ( = 108) were enrolled in a pre-post study with three visits. At visit 1, participants completed a baseline assessment and genetic testing via 23andMe. Participants' raw genetic data ( variants) and smoking heaviness were used to create a tailored tool that communicated personalized risks of smoking-related diseases and evidence-based recommendations to promote cessation. Participants received their personalized intervention at visit 2, approximately 6 weeks later. Visit 3 involved a telephone-based follow-up assessment 30 days after intervention. Of enrolled participants, 83% were retained across the three visits. Immediately following intervention, acceptability of was high (M = 4.4; SD = 0.6 on scale of 1 to 5); at 30-day follow-up, 89% of participants demonstrated accurate recall of key intervention messages. In the full analysis set of this single-arm trial, cigarettes smoked per day decreased from intervention to 30-day follow-up [11.3 vs. 9.8; difference = 1.5; 95% confidence interval (0.6-2.4); = 0.001]. A personalized genetically informed risk tool was found to be highly acceptable and associated with a reduction in smoking, although the absence of a control group must be addressed in future research. This study demonstrates proof of concept for translating key basic science findings into a genetically informed risk tool that was used to promote progress toward smoking cessation. This study demonstrates that personal genetic information can be incorporated into a risk feedback tool that was highly acceptable to current smokers and associated with reductions in smoking. These findings may pave the way for effectiveness and implementation research on genetically-informed behavior change interventions to enhance cancer prevention efforts.
关于个性化遗传风险信息对吸烟的可能影响,人们知之甚少,而吸烟是发病率和死亡率的首要可预防原因。我们研究了在当前吸烟者中,一种个性化遗传风险工具的可接受性和潜在行为改变。当前吸烟者(n=108)参与了一项有三个访问的前后研究。在第一次访问中,参与者完成了基线评估和 23andMe 的基因测试。参与者的原始基因数据(变体)和吸烟量用于创建一个定制的工具,该工具传达与吸烟相关疾病的个性化风险和促进戒烟的循证建议。大约 6 周后,参与者在第二次访问中收到了他们的个性化干预。第三次访问包括干预后 30 天的电话随访评估。在登记的参与者中,83%在三次访问中都得到了保留。干预后立即,对 的可接受性很高(量表 1 到 5,平均值为 4.4;标准差为 0.6);在 30 天随访时,89%的参与者准确回忆起了关键的干预信息。在这项单臂试验的全分析集中,每天吸烟的数量从干预到 30 天随访减少了[11.3 比 9.8;差异=1.5;95%置信区间(0.6-2.4);P=0.001]。研究发现,一种个性化遗传风险工具非常容易被接受,并与吸烟量减少相关,尽管未来的研究必须解决没有对照组的问题。这项研究证明了将关键基础科学发现转化为促进戒烟的遗传风险工具的概念验证。这项研究表明,个人遗传信息可以被纳入一个高度被当前吸烟者接受的风险反馈工具,与吸烟减少有关。这些发现可能为在遗传信息干预方面开展有效性和实施研究铺平道路,以加强癌症预防工作。